We carried out an announced comprehensive inspection on 14 February 2017 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Barrowford Dental Practice offers a full range of dental treatments including preventative, corrective and cosmetic treatments. The practice is based in the centre of Barrowford in Lancashire, close to the main shops. The team consists of five dentists, three dental hygienists, a dental hygiene therapist, seven dental nurses (one of which is a trainee), a dental technician, a receptionist and a cleaner.

The practice is in a purpose built building. There are four treatment rooms, a decontamination room, an office/ staff area and a waiting/ reception room. Public parking is available near the practice. The opening hours are Monday 8am-8pm, Tuesday 8am-6:00pm, Wednesday 8am-5:00pm, Thursday 8am-6:00pm and Friday 8am-5pm.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual registered person. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Our key findings were:

• The practice had procedures in place to record and analyse significant events and incidents.
• Staff had received safeguarding training, and knew the process to follow to raise concerns.
• There were sufficient numbers of suitably qualified, skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, but some emergency medicines and equipment were out of date.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients, and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice gathered the views of patients and staff and took their views into account.
• Staff were supervised, felt involved, and worked as a team.
• The premises were visibly clean and tidy but improvements could be made in the management of the cleaning equipment and materials to prevent cross infection.

There were areas where the provider could make improvements and should:

• Review the equipment used for medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the provision of policies and procedures for example recruitment and lone working and that COSHH information is in place and accessible to all staff.
• Review the implementation of the legionella review and subsequent recommendations ensuring water temperatures are regularly checked and recorded in line with the guidance.

At the practice we spoke with six people using the service (patients), three members of staff, including the practice manager, the principal dentist (and registered manager) and the 'foundation' dentist.

Patients felt all the staff treated them in a pleasant and respectful manner, and were good at making them feel comfortable. One patient said, "The staff are fantastic; I'm always treated really well". Another said, "It's a good experience; they make you feel at ease".

People's right to private discussions/consultations was upheld and these took place in the dentists' surgeries. Patients felt they were given enough information about treatment options, and the relevant fees, which enabled them to make choices about the best option. They said the dentists discussed these things properly with them. One person said, "The treatment is always explained as we go along and my dentist is interested in me".

Patients told us they were very satisfied with their dental care and treatment. One said, "It's an excellent service" and "I have a lot of confidence in my dentist". Another patient said, "Nothing is too much trouble". People confirmed they could see the dentist at short notice and that the appointment system enabled them to see their dentist as needed.

People also thought the facilities and the premises were pleasant and clean and hygienic. They had also observed the staff undertaking correct hygiene procedures such as hand washing and wearing gloves and face 'visors'.